UWorld MQ1 Flashcards
HIV DRUG : NRTI
Zidovudine
Tenofovir
emtricitabine
NRTI MOA
inhibits HIV DNA synthesis from RNA template by terminating DNA chain elongation
NNRTI
EfaVIRenz
NeVIRapine
NNRTI MOA
allosteric RT inhibits: terminate DNA chain enlongation
PI drugs: Navir
Atazanavir
darunavir
ritonavir
indinavir
PI MOA
inhibits HIV poly protein cleavage
Integrase Inhibitor MOA
inhibits HIV DNA integration into host genome
Fusion inhibitor: binds to HIV gp41
EnFUvirtide
CCR5 antagonist: allosteric gp120 interaction
Maraviroc: blocking entry
how is resistance developed to NNRTIs
point mutation in RT region of Pol gene
gremlin mutation of VHL gene
AD
renal cell carcinoma
pheochrom
RB
Kayser-Fleischer rings in Wilson dz
Incre copper, dec ceruloplasmin
Cornea deposition
Treat with zinc and chelation(D-penicillinamine)
Breast fat necrosis clues
Post traumatic
Irregular mass
Central necrosis liquefactive fat
Neutrophil & macrophages
Breast: solitary firm round mass with clear borders, fibrous capsules, tan/white on cross section
Fibroadenoma
Cyclical premenstrual tender breast
Blue or brown fluid
Fibrocystic changes
Dysplastic nevus syndrome mutation
CDKN2A (p16)
multiple scattered skin lesions with irregular nuclear contours, round or spindle shape cells will develop
melanoma
DNA synthesis reaction begins in
cytoplasm
carbamoyl phosphate synthetase II
Antifungal: Cell wall
Caspofungin
antifungal: mitosis
Griseofulvin
anti fungal DNA& RNA synthesis
Flucytosine
Antifungal Cell membrane
Amphotericin B &Nystatin bind ergosterol
Azoles inhibit synthesis of ergosterol
single enlarged parathyroid
parathyroid adenoma
excess secretion of hormones causes hypercalcemia and neg feedback causing atrophy of other gland
MOA of vit A analog alter gene expression to
normalizes keratinization
decreased epithelial cohesiveness
stimulated stem cell mitosis
strongest risk factor for MI
smoking
oxidize LDL=accelerate atherosclerosis
increase catecholamine =vasoconstriction
vasculitis and endothelial cell dysfunction
pharm
Streptomycin
MOA
aminoglycoside
inactivatinng the 30S(small) Ribosomal Subunit
altered structure of bacterial ribosomal protient cause resistance
Rifampin MOA
Inhibition of bacterial DNA-dependent RNA polymerase
SE: Red-orange body fluids, cytopenia, GI effects
Isoniazid MOA
Inhibition of mycolic acid synthesis
Niacin defi(skin rash)
Neurotoxic(B6), hepatotoxicity
Pyrazinamide SE
Unclear MOA
Hepatotoxicity
hyperuricemia
Ethanbutol MOA
inhibition of arabinosyl transferase
Optic neuropathy
Increase activity of enzymes involved in cell wall polysaccharide synthesis
arabinosyl transferase
Ethambutol
Decreased activity of bacterial catalase peroxidase
inhibition of mycolic acid
INH
Altered the structure of enzymes involved in DNA winding-unwinding
Rifampin
2 phases of Hep B progression
Proliferative phase and integrative phase
To activate MHC I, HepB present with
CD 8 activation causes cytotoxic effect
entire virion, HBsAg and HBcAg on hepatocyte cell surface
appropriete med for long-term management of Bipolar
Lithium
Nephrogenic Diabetis, hypothyroid, chronic interstitial nephritis
treatment option of bipolar maintenance
lithium,
valproate,
lamotrigine
lithium may decr suicidal ideation
MALT Lymphoma may be cause by
chronic immune stimulation
mc trigger of gastric MALT lymphoma
H. pylori
Ecoli V. factor & function
Lipopolysaccharide
activates macrophages to
release IL-1, IL-6, TNF-a
septic shock/bacteremia
Ecoli V. factor & function
K1 capsular polysaccharide
prevents phagocytosis and complement-mediated lysis
Neonatal meningitis
Ecoli V. factor & function
Shiga toxin
block 60S: protein synthesis/cell death
Bloody diarrhea
Ecoli V. factor & function
heat-stable/heat-labile enterotoxins
promotes fluid
electrolytes secretion from intestinal epithelium
watery diarrhea
Ecoli V. factor & function
P-frimbriae
adhesion to uroepithelium
urinary tract infection
hi dose IL-2 MOA
produced by activated CD4/8 & NK cells
enhance activity of natural killer cells
IL-2 effect of cd4
proinflammatory
converts to T helper 1+–> IFN-Y/A, IL-2
IL-2 effect of CD8
expands pool of CD8 for cytotoxic killing
hypotension, tachycardia, dental erosion
electrolyte abnormalities
low K, metabolic alkalosis
Bulimia nervosa
minimal change pathogenesis
T Cell- mediated injury to podocytes
first line treatment for candida
fluconazole
resistance to fluconozole
Mutations altering the enzyme of cell membrane ergosterol synthesis
resistance to azole
eflux pumps
increase 14-alpha-demethylase
mutate 14-a-demthylase
14-a dm covert lanosterol to ergosterol
in B12 deficiency you are missing
succinly-CoA and
Methionine/THF
what build up in B12 defi
methylmalonyl-CoA
Homosysteine
digoxin is fat or water soluble
water soluble
cleared by kidney
inhibition of glycosyltransferase enzyme affects
Mycoplasma
function of bacterial glycosyltransferase enzyme
add glycan to peptidoglycan chain of cell wall
target mycoplasma with
tetracycline
macrolides
ubiquitinated TDP-43
found in
Frontotemporal demetial
altered executive function
difficulty moving post antipsychotic drug
HTN, fever
NT affected
dopamine
MOA
Benztropine
antipsychotic
Block D2 Negrostiatal pathway
drug-induced parkinsonism treat with anticholinergic medication
Disease progression in Ankylosis Spondy
most helpful measurement
chest wall mobility
cardioinhibitory response in syncopy
increase parasympathetic to SA/AV node
vasodepressor
vasodepressor response to syncopy
decreased sympathetic output to vascular smooth muscle causing dialation
cirrhosis pt with fluid in the lung
hepatic hydrothorax
fluid moving across diaphragm
phthirus pubis treatment
pubic louse
topical permethrin
function of aromatase
Dificiency in the placenta
converts androgens to estrogen
hi androgen during pregnancy-->ambigous external genetalia
Maternal and female fetus verilization
If pt can’t use aspirin
alternate antiplatelet irreversible blocks P2Y-ADP receptor
clopidogrel
use to prevent cardiovascular event
Aspirin
clopidogrel
cilostazol moa
treats?
phospodiesterase inhibitor
claudication: peripheral vascular dz
cytocine deamination DNA repair sequenes
base excision repair
glycosylase
endonuclease,
lyase,
polymerase
lygase
synergistic activity of simvastatin and cholestyramine
cholestyramine— increase cholesterol syn
simvastatin—Inhibit cholestrol syn
lowers cholesterol
what is Programmed-death receptor 1(PD-1)
used by cancer cells to downregulate
cytotoxic T-cell
MOA of Pembrolizumab
blocks PD-1
restore CD 8 T-cell killing ability
trisomy 21 Cardiac presentation
AV septal defect
VSD
ASD
trisomy 21 GI
duodenal atresia
hirschsprung dz
trisomy 21 oncology
acute leukemia
trisomy 21 orthopedic
atlantoaxial instability
trisomy 21 neuro
intelectual disability
alzheimer dz
Amiodaron
Class III SE
Bradycardia
hepatic toxic
thyroid dysf
Metoprolol
SE
Bradycardia
advanced AV block
Adenosine
MOA hyperpolarize nodal pacer
flushing/Low BP
Bronchospasm
Hi-grade AV block
initial PSVT treament
Digoxin
SE
Bradycardic
Nausea & vomiting
yellow vision halo
Verapamil/diltiazem
Ca+ Blocker
bradycard
AV blocker
low ventricular contraction
constipation
ibutilide/dofetilide/sotalol
SE
Torsade de pointes
mc ectopic electrical foci causing A. Fib
pulmonary vein
treat with ablation
Treat Warfarin OD with
Vit K
FFP
treat heparin OD with
Protamin sulfate
lack of ApoE3 and ApoE4, lipid-laden macrophages shows inpairment of
chylomicron remnat uptake by liver cells
misattributing undesired thoughts or feeling to another person
projection
incomplete obliteration of the vitelline duct
meckel diverticulum
true diverticulum: mucosa, submucosa and muscularis
dz causing verying severity of maternal line
heteroplasmy
dz with AD patern causing varying severity
variable expression
Ecoli LPS bind to _______________-and activate NF-kB to transcribe _____________________
Toll-like receptor (PRR)
Proinflammatory (TNF-a, IL-1, IL-6, IL-12)
incident of spinal stenosis may result from enlargment of _____________ligament
ligmentum flavum
3 component of RAAS regulation
Macula densa
intrarenal baroreceptors
beta-adrenergic receptors
B1 blocks renin release
when etiology of Met. alkalosis is unknow, assess
volume status
urine chloride
low CL- impairs renal excretion of HCO3
primarily manic, may have depressive episodes
hospitalizaiton or marked social impairment
Bipolar I
major depression,
Hypomanic >4 days,
observable change from functioning baseline
no psychotic feature, no hospitilization
Bipolar II
responsible for wound reepithelization
keratinocytes
contact inhibition controls growth
lack of facial expression and monotone voice + psychotic symp.
neg symptom: flat affect
schizophrenia
pharyngitis and tonsillitis with grey-white pseudomembranes
Treatment
Diphtheria antitoxin**
Antibiotic
moa of DT exotoxin
booster vac. every 10 years
irreversibly inhibits host protein syn
ADP-ribosylation of EF-2
spherules containing endospores describes
parts of central and south America
coccidioides immitis
dimorphic fungus:
disruption of tissue O2 delivery by oxidizing agents
increase Lactic acidosis
Methemoglobinemia
(Nitrites, chloroquine)
cyanide tox of nitroprusside moa
blocks TCA electron trasport
pain in SI and pubic symphysis during pregnancy may be dt
relaxin prduction
by corpus lutium and placenta
Histology of pulmonary edema
engorged capillaries and alveoli filled with acellular pick material
histology of lung of pt with heart failure demostrate
hemosiderin-laden macrophages
leak from alveolar capillaries
presence of hi neutrophils in alveolar fluid
exudative alveolar
bacterial pneumonia
Goodpasture / vasculitides lung histology
histology presentation
focal necrosis of alveolar walls
intra-alveolar hemorrhage
Treatment
defective platelet surface glycoprotein receptor
binds finbrinogen in platelet aggregation
abciximab
Txt: unstable angina, acute coronary syndrome..: GP2b/3a antagonist
Defective outward K flow and prolongation of action potential causes ? Cardiac presentation
Amiodarone, sotalol, dofetilide (K blocker)
ventricular Tach & sudden death
congentital long QT syndrome
Which cytokines is proinflammatory
IL-12–> IFNy, IL-2, TNFa (Th1)
IL-17(Th17)
Anti-inflammatory cytokines
IL-4, IL-10(Th2)
Treg (IL-10, TGFb)
proinflammatory release from T helper 1
IFNy
TNFa
IL-2
association b/t exposure to risk modifier (treatmt) and outcome (disease course)
Exposed/non-exposed
RR
why is barium constrast studies and colonoscopy contraindicated in toxic megacolon(UC)
Risk of perforation
children with limited Iron intake first show decrease in which lab findings
Ferritin
parasite blood fluke infection
chronic hepatosplenomegaly, bladder cancer, anemia and hi eosinophile
asia, subsahara Africca
schistosomiasis